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单冻融囊胚移植周期中染色体结构重排的植入前基因检测后单胎活产的围产期结局:一项回顾性队列研究

Perinatal Outcomes of Singleton Live Births Following Preimplantation Genetic Testing for Chromosomal Structural Rearrangements in Single Frozen-Thawed Blastocyst Transfer Cycles: a Retrospective Cohort Study.

作者信息

Zheng Wei, Ren Bingnan, Mu Mingkun, Liu Yanli, Liu Xiaoyang, Yang Chen, Yang Shuheng, Yang Rujing, Li Jing, Zu Ruowen, Ran Shiyu, Wu Huan, Guan Yichun

机构信息

Department of Reproductive Medicine, The Third Affiliated Hospital of Zhengzhou University, No. 7 Kangfuqian Street, Erqi, Zhengzhou, 450052, Henan, China.

出版信息

Reprod Sci. 2022 Oct;29(10):3039-3046. doi: 10.1007/s43032-021-00732-x. Epub 2021 Oct 29.

Abstract

This study investigated whether singleton pregnancies conceived after preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR) are associated with a higher risk of adverse perinatal outcomes than singleton pregnancies conceived after intracytoplasmic sperm injection (ICSI). We collected data on singleton live births after PGT-SR (n = 107) and ICSI (n = 585) in our hospital from January 2017 to August 2020. Multivariable analyses were used to adjust for maternal age, body mass index, gravidity and parity, paternal age, ovulatory disorder, and recurrent spontaneous abortion. The unadjusted results showed a significantly higher risk of hypertensive disorders of pregnancy (HDP) (odds ratio (OR) = 2.47; 95% confidence interval (CI): 1.10-5.54; P = 0.029) associated with PGT-SR singleton pregnancies than with ICSI singleton pregnancies. However, after adjusting for potential confounders, there were no longer any significant differences in the risk of HDP (adjusted OR = 2.24; 95% CI: 0.92-5.48; P = 0.077) between PGT-SR and ICSI singleton pregnancies. There were no significant differences between PGT-SR and ICSI singleton pregnancies in terms of gestational diabetes, preterm premature rupture of membranes, placenta previa, cesarean delivery, gestational age (weeks), preterm delivery (< 37 weeks), very preterm delivery (≥ 28 weeks and < 32 weeks), birth weight (g), low birth weight (< 2500 g), very low birth weight (< 1500 g), birth height (cm), birth defects, and 1-min and 5-min Apgar scores. In conclusion, for single frozen-thawed blastocyst cycles, there were no significant differences in adverse perinatal outcomes between PGT-SR and ICSI singleton pregnancies. However, due to the limited sample size, these conclusions need to be confirmed by further studies.

摘要

本研究调查了经染色体结构重排植入前基因检测(PGT-SR)后受孕的单胎妊娠与经卵胞浆内单精子注射(ICSI)后受孕的单胎妊娠相比,是否具有更高的不良围产期结局风险。我们收集了2017年1月至2020年8月期间我院PGT-SR(n = 107)和ICSI(n = 585)后单胎活产的数据。采用多变量分析来调整产妇年龄、体重指数、孕次和产次、父亲年龄、排卵障碍和复发性自然流产等因素。未经调整的结果显示,与ICSI单胎妊娠相比,PGT-SR单胎妊娠发生妊娠高血压疾病(HDP)的风险显著更高(比值比(OR)= 2.47;95%置信区间(CI):1.10 - 5.54;P = 0.029)。然而,在调整潜在混杂因素后,PGT-SR和ICSI单胎妊娠之间HDP风险不再有任何显著差异(调整后OR = 2.24;95% CI:0.92 - 5.48;P = 0.077)。PGT-SR和ICSI单胎妊娠在妊娠期糖尿病、胎膜早破、前置胎盘、剖宫产、孕周(周)、早产(< 37周)、极早产(≥ 28周且< 32周)、出生体重(g)、低出生体重(< 2500 g)、极低出生体重(< 1500 g)、出生身高(cm)、出生缺陷以及1分钟和5分钟阿氏评分方面均无显著差异。总之,对于单冻融囊胚周期,PGT-SR和ICSI单胎妊娠之间的不良围产期结局无显著差异。然而,由于样本量有限,这些结论需要进一步研究证实。

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